Current Treatment Options in Cardiovascular Medicine

, Volume 9, Issue 1, pp 11–28

Utility of drug-eluting stents in complex lesions and high-risk patients


DOI: 10.1007/s11936-007-0047-9

Cite this article as:
Nikolsky, E. & Stone, G.W. Curr Treat Options Cardio Med (2007) 9: 11. doi:10.1007/s11936-007-0047-9

Opinion statement

Drug-eluting stents represent a breakthrough technology designed to deliver high concentrations of a bioactive agent locally to an atherosclerotic lesion, thereby minimizing systemic side effects of the drug. The safety and efficacy of drug-eluting stents have clearly been demonstrated in noncomplex lesions. This article presents an evidence-based analysis of the current experience with CYPHER sirolimus-eluting stents (Cordis Corp., Miami Lakes, FL) and TAXUS paclitaxel-eluting stents (Boston Scientific, Natick, MA) in a broad spectrum of high-risk and/or complex subsets of patients and lesions, including those with diabetes mellitus, multivessel disease, diffuse disease, very small vessels, lesions in saphenous vein grafts, chronic total occlusions, in-stent restenosis, ostial and bifurcation lesions, unprotected left main disease, and acute myocardial infarction. Emerging data in several of these subsets suggest that drug-eluting stents are safe and effective, and their use may currently be recommended, whereas in other groups of patients and lesions the efficacy and/or safety of drug-eluting stents remains to be determined, thus warranting caution. It is anticipated that penetration of drug-eluting stents will continue to increase, and fewer patients will require surgical revascularization to achieve sustained event-free survival.

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.Herbert Irving PavilionColumbia University Medical CenterNew YorkUSA